title: Paediatric and adolescent traumatic gastrointestinal injuries: results of a European multicentre analysis.
abstract: OBJECTIVE
  Paediatric gastrointestinal injuries (GIIs) are rare, and the aim of this multicentre study was to evaluate their outcomes in a large cohort.
  
  
  METHODS
  Hospital databases of 10 European paediatric surgical centres were reviewed for paediatric traumatic GIIs managed between 2000-2010.
  
  
  RESULTS
  Ninety-seven patients with a median age of 9 years (0-17 years) were identified, with 72 blunt and 25 penetrating GIIs. Initial diagnostics in 90 patients led to correct diagnosis in 71%. Diagnostics were delayed in 26 patients (median 24 h). Eighty-two patients required surgery (67 laparotomy, 12 laparoscopy and three other approaches). There was a 50% conversion in the laparoscopic group. Median hospital stay was 10 days (range 1-137 days), with longer duration influenced by associated injuries (n = 41). Diagnosis <24 h was associated with significantly shorter hospital stay compared to more than 24 h (p = 0.011). In one-third of patients, morbidities were not related to a diagnostic delay or type of injury. There were five lethal outcomes, four due to associated injuries.
  
  
  CONCLUSIONS
  Initial diagnostics in traumatic paediatric GIIs provide false negatives in one-third of patients. Diagnostic delay <24 h is associated with a significantly shorter hospital stay. Although laparoscopy is associated with a conversion rate of 50%, it can be used for diagnosis in suspected cases to avoid nontherapeutic laparotomy.
authors.affiliation: Department of Pediatric- and Adolescent Surgery, Medical University of Graz, Graz, Austria.
authors.forename: E E
authors.initials: EE
authors.lastname: Fischerauer
authors.forename: S
authors.initials: S
authors.lastname: Zötsch
authors.forename: C
authors.initials: C
authors.lastname: Capito
authors.forename: A
authors.initials: A
authors.lastname: Bonnard
authors.forename: S
authors.initials: S
authors.lastname: Sárközy
authors.forename: J
authors.initials: J
authors.lastname: Berndt
authors.forename: S
authors.initials: S
authors.lastname: Hosie
authors.forename: R
authors.initials: R
authors.lastname: Beltra Pico
authors.forename: G
authors.initials: G
authors.lastname: Steinau
authors.forename: A
authors.initials: A
authors.lastname: Wiejek
authors.forename: P
authors.initials: P
authors.lastname: Czauderna
authors.forename: A
authors.initials: A
authors.lastname: Çelik
authors.forename: A
authors.initials: A
authors.lastname: Lain Fernandez
authors.forename: V M
authors.initials: VM
authors.lastname: Ibanez
authors.forename: C
authors.initials: C
authors.lastname: Esposito
authors.forename: A K
authors.initials: AK
authors.lastname: Saxena
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005188:False Negative Reactions; D005260:Female; D041981:Gastrointestinal Tract / Q000293:injuries* / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy / Q000706:statistics & numerical data; D007813:Laparotomy / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D014950:Wounds, Penetrating / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy*
keywords: Children; Gastrointestinal injuries; Management; Outcome; Trauma